Students' device may improve chest closure after heart surgery

To operate on the heart, surgeons usually cut through the breastbone. After correcting the heart problem, they reconnect the sternum by piercing it with steel wires, pulling the bone segments together and twisting the wires tight. Because this half-century-old technique poses some risks to both the surgeon and the patient, undergraduates at The Johns Hopkins University have invented a less intrusive and potentially safer chest closure system that threads locking polymer clasps through the ribs.

The 11-member team's prototype won first-place honors in the university's recent Biomedical Engineering Design Day competition. The project's sponsor, Surgical Transformations LLC, has obtained a provisional patent covering the system. If the idea appeals to enough surgeons, the firm plans to support further research and development to produce a commercial model.

Malcolm Lloyd, a physician and co-owner of the company, said he and his partner, heart surgeon Mark Sumeray, challenged the students last year to devise a better way to close the chest after surgery. "The premise was based on an unmet need identified by cardiothoracic surgeons," Lloyd said. "The students came up with a working prototype that hit all of the engineering requirements we proposed. The end result was better than my partner and I expected, particularly given the limitations they had in terms of resources."

The students produced their prototype, which resembles a stapler and uses standard locking cable ties, for about $1,500. Much of this went to a private prototyping shop that built the device according to the students' detailed design drawings. A roughly 8-inch curved piece extends from the handheld tool to guide the tie between and under the ribs, enabling a surgeon to connect both ends and pull the severed sternum parts toward one another. When one end of the tie is reinserted into the tool and the handles are squeezed, the device operates like a ratchet, tightening the clasp

Contact: Phil Sneiderman
Johns Hopkins University

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